Clinical, Laboratory, and Interferon-Alpha Response Characteristics of Patients With Chilblain-like Lesions During the COVID-19 Pandemic
| Autor: | Julie Contenti, Florence Le Duff, Zoubir Adjtoutah, Valérie Giordanengo, Nathalie Cardot-Leccia, Olivier Bausset, Bérengère Dadone-Montaudié, Géraldine Gonfrier, Fanny Burel-Vandenbos, Pascal Giordana, Thierry Passeron, V. Mondain, Jean Dellamonica, Vincent Raimondi, Véréna Fassbender, Barbara Seitz-Polski, Margaux Garnier, Aurélia Palladini, Christine Chiaverini, Thomas Hubiche, Georges Leftheriotis, Johan Courjon |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Alpha interferon Dermatology Serology Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Child education Chilblains Prospective cohort study Aged education.field_of_study Acrocyanosis business.industry Brief Report COVID-19 Interferon-alpha Middle Aged medicine.disease Cryoglobulinemia 030220 oncology & carcinogenesis Cohort Female business |
| Zdroj: | JAMA Dermatology JAMA Dermatol |
| ISSN: | 2168-6068 |
| DOI: | 10.1001/jamadermatol.2020.4324 |
| Popis: | Importance Chilblain-like lesions have been reported during the coronavirus 2019 (COVID-19) pandemic. The pathophysiology of such manifestations remains largely unknown. Objective To perform a systematic clinical, histologic, and biologic assessment in a cohort of patients with chilblain-like lesions occurring during the COVID-19 pandemic. Design, setting, and participants In this prospective case series carried out with a COVID-19 multidisciplinary consultation group at the University Hospital of Nice, France, 40 consecutive patients presenting with chilblain-like lesions were included. Main outcomes and measures Patients underwent a thorough general and dermatologic examination, including skin biopsies, vascular investigations, biologic analyses, interferon-alpha (IFN-α) stimulation and detection, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) and serologic analysis. Results Overall, 40 consecutive patients with chilblain-like lesions were included. Most patients were young, with a median (range) age of 22 (12-67) years; 19 were male and 21 were female. The clinical presentation was highly reproducible with chilblain-like lesions mostly on the toes. Bullous and necrotic evolution was observed in 11 patients. Acrocyanosis or cold toes were reported in 19 (47.5%) cases. Criteria compatible with COVID-19 cases were noted in 11 (27.5%) within 6 weeks prior to the eruption. The real-time PCR (rt-PCR) testing results were negative in all cases. Overall, SARS-CoV-2 serology results were positive in 12 patients (30%). D-dimer concentration levels were elevated in 24 (60.0%) cases. Cryoglobulinemia and parvovirus B19 serologic results were negative for all tested patients. The major histologic findings were features of lymphocytic inflammation and vascular damage with thickening of venule walls and pericyte hyperplasia. A significant increase of IFN-α production after in vitro stimulation was observed in the chilblain population compared with patients with mild-severe acute COVID-19. Conclusions and relevance Taken together, our results suggest that chilblain-like lesions observed during the COVID-19 pandemic represent manifestations of a viral-induced type I interferonopathy. Trial registration ClinicalTrials.gov Identifier: NCT04344119. |
| Databáze: | OpenAIRE |
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